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Psychoanalysis more effective than shorter psychotherapies?

March 24, 2014

Mind the Brain blog has a usefully sceptical consideration of a recent study published in JAMA whihc purported to show via a meta-study that long-term psychodynamic psychotherapy is superior to shorter therapies and also to non-psychodynamic treatments:

A meta-analysis in the Journal of the American Medical Association (JAMA) makes that claim [PDF available here]. It is accompanied by a glowing editorial. The authors of the JAMA paper, Leichsenring and Rabung, have also repeated their claims in redundant articles published in other the journals. And their claims have been echoed enthusiastically by proponents of LTPP around the world.

It is well worth reading the original paper and the editorial. It made energising and gratifying reading for the international psychodynamic and psychoanalytic community who have been fighting what seemed to be an unstoppable tide of negativity, and the associated danger of being excluded from officially recommended treatments.

However, the author of Mind the Brain blog ( James Coyne PhD ) has some good points to make specifically regarding this much hyped survey.

Read on and you’ll

Romp with me through the many problems that apparently slipped by unnoticed in the publication of a meta-analysis in a high impact journal.
Have your confidence shaken that publication in one of the highest impact medical journals is any reassurance of the trustworthiness of evidence and freedom from bias.
Get tips how to spot bad meta analyses being shaped for marketing and propaganda purposes.
Find a brief distraction in Bambi meets Godzilla, the animated  91-second video that has become a metaphor for confrontations between the practice of psychotherapy and the demand for evidence of cost-effectiveness.
Be left grappling with the broader issue of just how much politics and personal connections determine whether manuscripts get published in high impact journals and with accompanying editorials.

There is definitely a soundtrack of axes being ground, but this two part post makes for good reading, and there is also the video.


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